Leukoplakia

Figure 2.7. Speckled leukoplakia. This mixed white and red lesion of the buccal
mucosa showed moderate epithelial dysplasia (Courtesy of: Dr Crispian Scully). Pg
127
Tobacco pouch keratosis
Figure 2-10. Tobacco pouch keratosis. A white, wrinkled change of the mucosa in the
mandibular buccal vestibule secondary to the use of chewing tobacco. Pg 136
(Courtesy of: Drs. Regazi JA, Sciubba JJ, Pogrel MA )

Oral submucous fibrosis (OSF)

Figure 2-11. Advanced OSF with difficulty in mouth opening. Note the bilateral
pouching in of cheek while opening mouth. Pg 137
Figure 2-12 A. Advanced OSF. Horizontal fibrosis traversing at the junction of hard
and soft palate. Pg 137
Figure 2-12 B. Advanced OSF. Involvement of pterygomandibular raphae
compounding the difficulty of mouth opening. Pg 137
Figure 12-2 C. Carcinoma developed on the palate. Pg 137
Figure 2-13. Advanced stage with fibrosis of lamina propria and submucosa
Van-Gieson stain. Pg 139
Figure 2-14. Early OSF. Note the sparing of lamina propria from fibrosis
Van-Gieson stain. Pg 139
Epidermoid carcinoma
Figure 2-21. Increased number of mitotic figures per field.
(H&E stain). Pg 149
Figure 2-22. Squamous cell carcinoma with spindle metaplastic features. Pg 150
Figure 2-26 A to C. Epidermoid carcinoma of the tongue, early to advanced. Pg 157
Figure 2-27. Epidermoid carcinoma of the floor of the mouth. Pg 158
Figure 2-30. Epidermoid carcinoma of the palate. Pg 162

Malignant melanoma
Figure 2-34 A to C. Typical lesions involve the palate and alveolar ridge. Pg 175
Figure 2-35. Advanced OSF withhigh Ag NOR count Pg 176
Giant cell tumor
Figure 2-45. Giant cell tumor.
Typical appearance of a benign giant cell tumor. Giant cells
with varying numbers of nuclei are arranged more or less
uniformly within a background of mononuclear cells.
(Courtesy of Dr KK Unni.) Pg 191
Nasopharyngeal angiofibroma
Figure 2-53. Sturge-Weber syndrome.
A, The unilateral distribution of angiomatous malformations which never crosses the
midline is pathognomic of the syndrome.
B, Unilateral involvement of palate with angiomatous malformation. Pg 205
Figure 2-54. Nasopharyngeal angiofibroma.
The dense fibrous quality of the stroma and the numerous
thin-walled vessels are characteristic of this entity.
(Courtesy of Dr Juan Rosai.) Pg 206
Osteoid Osteoma
Figure 2-59. Osteoid osteoma.
This is the central nidus of an osteoid osteoma composed
of irregular reactive new bone. Pg 215
Fibrosarcoma
Figure 2-65. Low power appearance of well-differentiated
fibrosarcoma. The tumor has a monotonous
hypercellular look with regimentation of nuclei. Mitotic
figures are common. Pg 221
Figure 2-66. Fibrosarcoma showing moderate degree
of nuclear pleomorphism. Pg 221
Benign fibrous histiocytoma
Figure 2-67. Benign fibrous histiocytoma of cheek
(intraoperative view).Pg 224

Liposarcoma
Figure 2-68. Liposarcoma.
Numerous tumor giant cells and malignant cells showing
features of lipoblasts. (Courtesy of Dr Juan Rosai.) Pg 227
Hemangiopericytoma
Figure 2-70. Dilated, thin-walled vessels as shown here
are common. These vessels simulate stag horns that
are often associated with hemangiopericytoma. Pg 230

Kaposis sarcoma
Figure 2-71
Kaposis sarcoma. Pg 232
Figure 2-72
Immunoreactivity for Factor VIII-related antigen in Kaposis sarcoma
(courtesy of: Dr Juan Rosai). Pg 233
Ewing's sarcoma
Figure 2-73
Ewing's sarcoma is one of the "small round blue cell" tumors histologically. Note the
many mitotic figures in the field. Pg 234

Chondrosarcoma
Figure 2-76
This is the low power microscopic appearance of a chondrosarcoma. The tissue is
recognizable as cartilage, and there are chondrocytes in clear spaces, but there is no
orderly pattern. At the bottom, this neoplasm can be seen invading and destroying
bone. Pg 239

Osteosarcoma of the maxilla

Figure 2-78
Osteosarcoma of the maxilla.(courtesy of: Dr. Twinkle S. Prasad). Pg 242
Figure 2-80
The neoplastic spindle cells of osteosarcoma are seen to be making pink osteoid here.
Osteoid production by a sarcoma is diagnostic of osteosarcoma. Pg 244
Non-Hodgkins lymphoma

Figure 2-84
Follicular non-Hodgkins lymphoma. Pg 251

Burkitt lymphoma
Figure 2-87
Burkitt lymphoma presenting as a large tumour of the jaw in an African child.
(Courtesy of: WHO, World Cancer Report.2003) Pg 255
Figure 2-88
Starry sky appearance of Burkitts lymphoma. (Courtesy of: K.W. Lee). Pg 256

Hodgkin's disease
Figure 2-90. Reed-Sternberg cell.
Cells with large, pale nuclei containing purple nucleoli at
the arrowheads. These are Reed-Sternberg cells that are
indicative of Hodgkins disease. Most of the cellular content
of foci of Hodgkins disease consists of reactive lymphoid
cells. Pg 258

Multiple Myeloma
Figure 2-92 A
Multiple Myeloma: At low power, the abnormal plasma cells of multiple myeloma fill
the marrow. Pg 262
Figure 2-92 B
Multiple Myeloma: At medium power, the plasma cells of multiple myeloma here are
very similar to normal plasma cells, but they may also be poorly differentiated.
Usually, the plasma cells are differentiated enough to retain the function of
immunoglobulin production. Thus, myelomas can be detected by an immunoglobulin
"spike" on protein electrophoresis, or the presence of Bence-Jones proteins (light
chains) in the urine. Immunoelectrophroesis characterizes the type of monoclonal
immunoglobulin being produced. Pg 262
Figure 2-92 C
Multiple Myeloma: Here is a smear of bone marrow aspirate from a patient with
multiple myeloma. Note that there are numerous plasma cells with eccentric nuclei
and a perinuclear halo of clearer cytoplasm. Pg 262
Figure 2-92 D

Multiple Myeloma:The rounded "punched out" lesions of multiple myeloma appear as

lucent areas with this skull radiograph. Pg 262

Leiomyosarcoma
Figure 2-96
Leiomyosarcoma of oral cavity. Note the prominent cytoplasmic vacuoles indenting
to the nuclear poles. Pg 271
(Courtesy of: Dr Juan Rosai)

Neurofibromas
Figure 2-101 C
Multiple neurofibromas of the face. Pg 281
Figure 2-101 D
Neurofibromatosis showing spindled, wavy nuclei in fascicular form. Pg 281
Figure 2-102. Plexiform neurofibroma of the gingiva.
Abundant nerve tissue in fascicles and collagenous fibrous
stroma in ordered arrangement. Pg 282
Malignant peripheral nerve sheath tumor
Figure 2-105
Pigmented neuroectodermal tumour of infancy. The neoplastic islands located
between the bone trabeculae contain abundant melanin pigment. Pg 287
Metastatic carcinoma of the lower jaw
Figure 2-107 A. Metastatic carcinoma of the lower alveolus. Pg 290
Figure 2-107 B. Primary from prostate. Pg 290
Figure 2-107 C. An osteolytic lesion of the mandible. Pg 290
Figure 2-107 D. Photomicrograph of metastatic carcinoma of the alveolus. Pg 290